Stingl Julia V, Braun Cordula, Walter Sara, Rezapour Jasmin, Wagner Felix M, Shen Lucy, Strzalkowska Alicja, Schmidtmann Irene, Schuster Alexander K, Hoffmann Esther M
Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany.
Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
Transl Vis Sci Technol. 2025 Apr 1;14(4):24. doi: 10.1167/tvst.14.4.24.
To compare the peripapillary retinal nerve fiber layer (pRNFL) thickness of large optic discs in children (LOD-C) with normal sized optic discs in children (NOD-C) and large optic discs in adults (LOD-A).
We included 127 eyes per group (n = 381). Optic discs were considered large if the Bruch's membrane opening (BMO) area was ≥2.5 mm2. pRNFL thickness and minimal rim width (BMO-MRW) were compared between the pediatric groups and the large optic disc groups.
The mean global pRNFL thickness (3.5-mm circle) was 100.2 ± 12.1 µm for LOD-C, 95.9 ± 11.7 µm for NOD-C, and 97.7 ± 10.5 µm for LOD-A. It was significantly thicker in LOD-C compared with NOD-C; the difference decreased toward the periphery. The mean global BMO-MRW was 280.0 ± 41.1 µm for LOD-C, 320.7 ± 10.5 µm for NOD-C, and 252.9 ± 45.8 µm for LOD-A. It was significantly thinner in LOD-C compared with NOD-C, and significantly thicker in LOD-C compared with LOD-A. pRNFL and BMO area showed a positive correlation which was higher if BMO area was >2.8 mm2, BMO-MRW and BMO are showed a negative correlation which was higher if BMO area was <1.9 mm2.
RNFL and BMO-MRW of pediatric optic discs with BMO area <1.9 mm2 and >2.8 mm2 should be interpreted with caution, because they seem to be strongly influenced by optic disc size.
The novel thresholds for small and LOD-C will help to account for the effects of disc status on RNFL and MRW. They will furthermore help clinicians to better diagnose children with suspicious discs for glaucoma.
比较儿童大视盘（LOD-C）、儿童正常大小视盘（NOD-C）及成人大视盘（LOD-A）的视乳头周围视网膜神经纤维层（pRNFL）厚度。
每组纳入127只眼（n = 381）。如果布鲁赫膜开口（BMO）面积≥2.5 mm²，则视盘被视为大视盘。比较儿童组与大视盘组之间的pRNFL厚度和最小边缘宽度（BMO-MRW）。
LOD-C组平均整体pRNFL厚度（3.5-mm环）为100.2±12.1 µm，NOD-C组为95.9±11.7 µm，LOD-A组为97.7±10.5 µm。与NOD-C组相比，LOD-C组明显更厚；差异向周边减小。LOD-C组平均整体BMO-MRW为280.0±41.1 µm，NOD-C组为320.7±10.5 µm，LOD-A组为252.9±45.8 µm。与NOD-C组相比，LOD-C组明显更薄，与LOD-A组相比，LOD-C组明显更厚。pRNFL与BMO面积呈正相关，如果BMO面积>2.8 mm²，相关性更高；BMO-MRW与BMO面积呈负相关，如果BMO面积<1.9 mm²，相关性更高。
BMO面积<1.9 mm²和>2.8 mm²的儿童视盘的RNFL和BMO-MRW应谨慎解读，因为它们似乎受视盘大小的强烈影响。
小视盘和LOD-C的新阈值将有助于解释视盘状态对RNFL和MRW的影响。它们还将帮助临床医生更好地诊断患有可疑青光眼视盘的儿童。
